Pharmacy Fee For Service Prior Authorization (PA) Contacts
Change Healthcare Pharmacy PA Unit
Registered Users in the Change Healthcare PA Portal
If you are a Mississippi Medicaid prescriber, submit your Fee For Service prior authorization requests through the Change Healthcare provider portal.
- Register or submit prior authorization requests through the Change Healthcare provider portal.
- MississippiCAN prior authorizations
|Prior Authorization Packets||Updated|
|Brand Name Multi-Source||6/21/2019|
|EPSDT – Beneficiaries Under 21||6/28/2019|
|Hepatitis C Therapy||6/1/2021|
|Max Unit Override||6/21/2019|
|Multiple Concurrent Antipsychotics for Beneficiaries (Age < 18)||6/21/2019|
|Opioid Packet – Effective 8/1/2019 FAQs||9/10/2019|
|PDL Exception Request||6/21/2019|
|RSV-SYNAGIS® (effective until March 5, 2021)||9/30/2020|
|Universal Prior Authorization Form||6/21/2019|